Choledochal cysts
Much about the etiology, pathophysiology, natural course and optimal treatment of cystic disease of the biliary tree remains under debate. Gastroenterologists, surgeons and radiologists alike still strive to optimize their roles in the management of choledochal cysts. To that end, much has been written about this disease entity, and the purpose of this 3-part review is to organize the available literature and present the various theories currently argued by the experts. In part 1, we discuss the background of the disease, describing the etiology, classification, pathogenesis and malignant potential of choledochal cysts.
Choledochal cyst classification.
(A) Type-IA cystic dilation of the extrahepatic duct.
(B) Type-IB focal segmental dilation of the extrahepatic duct.
(C) Type-IC fusiform dilation of the entire extrahepatic bile duct.
(D) Type-II simple diverticula of the common bile duct.
(E) Type-III cyst/choledochocele distal intramural dilation of the common bile duct within the duodenal wall.
(F) Type-IVA combined intrahepatic and extrahepatic duct dilation.
(G) Type-IVB multiple extrahepatic bile duct dilations.
(H) Type-V/Caroli disease multiple intrahepatic bile duct dilation.